Head & Neck Anatomy

Last updated 20.09.12

 

Index

 

-  Bones

-  Joints

-  Movements & ROM

-  Muscles

-  Fascia

-  Trigger Points

-  Arterial Supply

-  Venous Drainage

-  Lymphatic Drainage

-  Innervation

-  Cutaneous Innervation

-  Organs

-  Dermatomes

-  Reflexes

-  Regional Anatomy

-  Surface Anatomy

-  Acupuncture

 

 

 

 

Bones of the Head & Neck

<Head & Neck Anatomy>

 

 

-  Skull

-  Parietal bone

-  Occipital bone

-  Frontal bone

-  Temporal bone

-  Sphenoid bone

-  Ethmoid bone

-  Inferior Conchae

-  Zygomatic bone

-  Maxilla

-  Nasal bone

-  Vomer

-  Palantine bone

-  Lacrimal bone

-  Mandible

-  Hyoid

 

 

 

Parietal Bone - paired

 

 

Occipital Bone

 

-         External Occipital Protuberance

-         External Occipital Crest

-         Occipital Condyle

-         Basiocciput

-         Foramen Magnum

o         Transmits

§         Medulla oblongata

§         Meninges

§         Vertebral arteries

§         Meningeal branches of vertebral arteries

§         Spinal roots of accessory nerve

-         Condylar Foramen

o         Transmits condyloid emissiary vein

-         Hypoglossal Canal

o         Transmits hypoglossal nerve (cranial nerve X)

-         Jugular Foramen

o         Between occipital and temporal bones

o         Transmits

§         Accessory nerve

§         Vagus nerve

§         Glossopharngeal nerve

§         Internal jugular vein

 

 

Frontal Bone

 

-         Glabella

-         Supraorbital Foramen

o       Transmits supraorbital artery branch of opthalmic artery

 

-         Foramen Cecum  - between frontal and ethmoid bones, transmits emissiary vein to superior sagital sinus

 

 

Temporal Bone - paired

 

-         Styloid Process

o         Attachment for stylohyoid muscle

-         Mastoid Process

o         Attachment for sternocleidomastoid muscle

-         Zygomatic Process

o         Creates zygomatic arch with temporal process of zygomatic bone

-         External Auditory Meatus

-         Internal Accoustic Meatus

o         transmits facial nerve, vestibulocochlear nerve

-         Carotid Canal

o         transmits internal carotid artery, internal carotid nerve plexus

o         opens into lateral end of foramen lacerum

-         Mastoid Foramen

o         transmits branch of occipital atrery to dura mater, mastoid emissiary vein

-         Stylomastoid Foramen

o         transmits facial nerve

 

 

Sphenoid Bone

 

-         Lesser Wing

o         Anterior Clinoid Process

-         Superior Orbital Fissure

o         Transmits frontal nerve, lacrimal nerve and nasocilliary nerve branches of opthalmic nerve (trigemminal nerve), occulomotor nerve, abducens nerve, trochlear nerve, superior opthalmic vein

-         Greater Wing

o         Foramen Spinosum

§         transmits middle meningeal artery branch of maxillary artery (internal carotid artery)

o         Foramen Rotundum

§         transmits maxilliary nerve (trigemminal nerve)

§         opens inferiorly into pterygopalatine fossa

o         Foramen Ovale

§         transmits mandibular nerve (trigemminal nerve)

o         Optic Canal

§         transmits optic nerve, opthalmic artery (internal carotid artery)

-         Sellae Turcicia (Turkish Saddle)

o         Tuberculum Sellae

o         Dorsum Sellae

o         Hypohyseal Fossa (Pituitary Fossa)

-         Pterygoid Process

o         Medial Pterygoid Plate

§         Attachment site of medial pterygoid muscle

o         Lateral Pterygoid Plate

§         Attachment site of lateral pterygoid muscle

-         Posterior Clinoid Process

 

 

Ethmoid Bone 

 

n      Cristae Gali

n      Olfactory Formaina

n      Cribriform Plate - transmits olfactory nerve, olfactory bulb

n      Foramen Cecum - between frontal and ethmoid bones, transmits emissiary vein to superior sagital sinus

n      Anterior Ethmoidal Foramen - transmits anterior ethmoidal artery branch of opthalmic artery, anterior ethmoidal nerve branch of long ciliary nerve (nasociliary nerve branch of opthalmic nerve branch of trigemminal nerve ), anterior ethmoidal vein

n      Posterior Ethmoidal Foramen - transmits posterior ethmoidal artery branch of opthalmic artery, posterior ethmoidal nerve branch of long ciliary nerve (nasociliary nerve branch of opthalmic nerve branch of trigemminal nerve), posterior ethmoidal vein

 

 

Inferior Turbinates or Inferior Concha - paired

 

 

 

Zygomatic Bone- paired

 

n      Temporal Process - creates zygomatic arch with zygomatic process of temporal bone

 

 

 

Maxilla - paired

 

n      Alveolar Margin

n      Incisive Fossa

n      Orbital Surface

n      Infraorbital Foramen - transmits infraorbital nerve branch of maxillary nerve (trigeminal nerve), infraorbital artery branch of maxillary artery (internal carotid artery)

n      Zygomaticofacial Foramen - zygomaticofacial nerve

n      Inferior Orbital Fissure

n      transmits zygomatic nerve branch of maxillary nerve (trigemminal nerve)

 

 

Nasal Bone – paired

 

 

Vomer

 

 

Palantine Bone- paired

 

n      Vertical Plate

n      Orbital Surface

n      Horizontal Plate

 

 

Lacrimal Bone - paired

 

n      Lacrimal Fossa

 

 

 

Mandible

 

n      Coronoid Fossa

n      Mandibular Condyle

n      Ramus of Mandible

n      Mandibular Angle

n      Body

n      Alveolar Margin

n      Mandibular Notch

n      Mental Foramen - transmits mental nerve branch of inferior alveolar nerve (mandibular nerve branch of trigemminal nerve), mental artery branch of inferior alveolar artery (maxillary artery branch of external carotid artery)

n      Mandibular Foramen - transmits inferior alveolar nerve branch of mandibular nerve (trigemminal nerve), inferior alveolar artery branch of maxillary artery (external carotid artery)

 

 

Hyoid

n      Greater Horn or Greater Cornu

n      Lesser Horn or Lesser Cornu

n      Body

 

 

 

 

 

Joints of the Head & Neck

<Head & Neck Anatomy>

 

 

-  Sutures of the Skull

-  Tempromandibular Joint

-  Atlanto-occipital Joint

-  Atlantoaxial Joint

-  Intervertebral Joints

 

 

 

 

Movements & ROM of the Head & Neck

<Head & Neck Anatomy>

 

 

-  Descriptions

-  Flexion

-  Extension

-  Abduction

-  Adduction

-  Circumduction

-  External (Lateral) Rotation

-  Internal (Medial) Rotation

 

 

 

 

Muscles of the Head & Neck

<Head & Neck Anatomy>

 

 

-   

 

 

 

Palatoglossus Muscle

only muscle of the tongue not supplied by the hypoglossal nerve, also called glossopalatinus muscle

Origin:

Insertion:

Action:

Innervation:

Blood Supply:

 

Palatopharyngeus Muscle

also known as pharyngopalatinus muscle

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Tensor Veli Palatini Muscle

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Levator Veli Palatini Muscle

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Salpingopharyngeus Muscle

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Stylopharyngeus Muscle

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Levator Scapulae Muscle

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Musculus Uvula Muscle

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Anterior Scalene Muscle

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Middle Scalene Muscle

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Posterior Scalene Muscle

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Nasalis Muscle (Compressor Naris Muscle, Dilator Naris Muscle)

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Depressor Septi Muscle

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Aleeue Nasi Muscle

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Procerus Muscle

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Temporoparietalis Muscle

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Splenius Capitis Muscle

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Splenius Cervicis Muscle

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Semispinalis Capitis Muscle

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Semispinalis Cervicis Muscle

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SUBOCCIPITAL MUSCLES

All supplied by posterior primary ramus of C1 (suboccipital nerve)

All supplied by vertebral artery and descending branch of occipital artery

 

Obliquis Capitis Inferior Muscle

Origin: spine of axis

Insertion: transverse process of atlas

Action: rotates atlas and skull around odontoid process of axis

Innervation: posterior primary ramus of C1 and C2

Blood Supply: vertebral artery and descending branch of occipital artery

 

Obliquis Capitis Superior Muscle

Origin: transverse process of atlas

Insertion: above inferior nuchal line (occipital)

Action: extension and lateral rotation of head

Innervation: posterior primary ramus of C1 (suboccipital nerve)

Blood Supply: vertebral artery and descending branch of occipital artery

 

Rectus Capitis Posterior Major Muscle

Origin: spine of axis

Insertion: lateral inferior nuchal line (occipital)

Action: extension, lateral flexion and rotation of head

Innervation: posterior primary ramus of C1 (suboccipital nerve)

Blood Supply: vertebral artery and descending branch of occipital artery

 

Rectus Capitis Posterior Minor Muscle

Origin: posterior tubucel of atlas

Insertion: below inferior nuchal line (occipital)

Action: extension and lateral flexion of head

Innervation: posterior primary ramus of C1 (suboccipital nerve)

Blood Supply: vertebral artery and descending branch of occipital artery

 

MUSCLES OF TYMPANIC CAVITY

Supplied by branches of external carotid artery

 

Stapedius Muscle

Origin: cavity apex of pyramid

Insertion: posterior neck of stapes

Action: increases fluid tension in ear, dampens tympanic membrane, reduces damage from loud noise

Innervation: nerve to stapedius branch of facial nerve whilst in facial canal

ARTERIAL SUPPLY: superior tympanic artery, anterior tympanic artery, stylomastoid artery

 

Tensor Tympani Muscle

Origin: cartilage of eustachian tube and part of greater wing of sphenoid

Insertion: root of handle of maleus (hammer)

Action: tenses tympanic membrane

Innervation: mandibular nerve of trigemminal nerve through otic ganglion

ARTERIAL SUPPLY: superior tympanic artery

 

MUSCLES OF EXTERNAL AURICLE

 

Anterior Auricular Muscle

Origin: temporal fascia and galea aponeurosis

Insertion: anterior part of medial helix

Action: moves ear anteriorly

Innervation: temporal nerve of facial nerve

Blood Supply: superficial temporal artery branch of external carotid artery

 

Superior Auricular Muscle

Origin: temporal fascia and galea aponeurosis

Insertion: superior part of medial helix

Action: elevates ear

Innervation: temporal nerve of facial nerve

Blood Supply: superficial temporal artery branch of external carotid artery

 

Posterior Auricular Muscle

Origin: mastoid process

Insertion: lower part of cranial surface of auricle

Action: moves ear posteriorly (retracts)

Innervation: posterior auricular nerve branch of facial nerve

Blood Supply: posterior auricular artery branch of external carotid artery

 

PHARYNGEAL CONSTRICTOR MUSCLES

 

Inferior Pharyngeal Constrictor Muscle

Origin: oblique line of thyroid cartillage, side of cricoid, cricothyroid muscle

Insertion: posterior median raphe of pharynx, overlaps middle constrictor muscle

Action: contracts pharynx in swallowing

Innervation: pharyngeal plexus from glossopharyngeal nerve and vagus nerve, recurrent laryngeal nerve and external laryngeal nerve branches of vagus nerve

Blood Supply: inferior thyroid artery branch of thyrocervial trunk and ascending pharyngeal artery branch of external carotid artery

 

Middle Pharyngeal Constrictor Muscle

Origin: greater and lesser horns of hyoid, stylohyoid muscle, overlaps superior constrictor

Insertion: posterior median raphe

Action: contracts pharynx in swallowing

Innervation: pharyngeal plexus from glossopharyngeal nerve and vagus nerve

Blood Supply: ascending pharyngeal artery branch of external carotid artery

 

Superior Pharyngeal Constrictor Muscle

Origin: lower third of medial border of medial pterygoid plate (ethmoid), ptergomandibular ligament, side of tongue, alveolar process of mandible

Insertion: posterior median raphe, by aponeurosis to pharyngeal tubercule (occipital)

Action: contracts pharynx in swallowing

Innervation: glossopharyngeal nerve

Blood Supply: ascending pharyngeal artery branch of external carotid artery

 

MUSCLES OF PHONATION

All supplied by superior laryngeal artery (external carotid artery)

 

Cricothyroid Muscle

Origin: arch of cricoid cartillage

Insertion: lower surface of thyroid cartilage

Action: tenses vocal folds

Innervation: external laryngeal nerve branch of superior laryngeal nerve (vagus nerve)

Blood Supply: superior thyroid artery (external carotid artery) and inferior laryngeal artery branch of inferior thyroid artery (thyrocervical trunk)

 

Posterior Cricoarytenoid Muscle

Origin: posterior surface of cricoid cartilage at midline

Insertion: arytenoid cartilage

Action: abducts vocal cords

Innervation: recurrent laryngeal nerve branch of vagus nerve

Blood Supply: superior laryngeal artery branch of superior thyroid artery (external carotid artery) and inferior laryngeal artery branch of inferior thyroid artery (thyrocervical trunk)

 

Lateral Cricoaretynoid Muscle

Origin: lateral aspect of cricoid arch

Insertion: arytenoid cartilage

Action: adducts vocal cords

Innervation: recurrent laryngeal nerve branch of vagus nerve

Blood Supply: superior laryngeal artery branch of superior thyroid artery (external carotid artery) and inferior laryngeal artery branch of inferior thyroid artery (thyrocervical trunk)

 

Transverse Arytenoid Muscle

Origin: arytenoid cartilage

Insertion: muscular process of contralateral arytenoid cartilage

Action: adducts vocal cords

Innervation: recurrent laryngeal nerve branch of vagus nerve

Blood Supply: superior laryngeal artery branch of superior thyroid artery (external carotid artery) and inferior laryngeal artery branch of inferior thyroid artery (thyrocervical trunk)

 

Vocalis Muscle

Origin: internal, inferior and anteromedial thyroid cartilage

Insertion: vocal process of arytenoid cartilage

Action: relaxes vocal cords

Innervation: recurrent laryngeal nerve branch of vagus nerve

Blood Supply: superior laryngeal artery branch of superior thyroid artery (external carotid artery) and inferior laryngeal artery branch of inferior thyroid artery (thyrocervical trunk)

 

Thyroarytenoid Muscle

Origin: internal, inferior and anteromedial thyroid cartilage

Insertion: muscular process and lateral surface of arytenoid cartilage

Action: relaxes vocal cords

Innervation: recurrent laryngeal nerve branch of vagus nerve

Blood Supply: superior laryngeal artery branch of superior thyroid artery (external carotid artery) and inferior laryngeal artery branch of inferior thyroid artery (thyrocervical trunk)

 

LARYNGEAL SPHINCTER MUSCLES

All supplied by superior laryngeal artery branch of superior thyroid artery (external carotid artery)

 

Oblique Arytenoid Muscle

Origin: muscular process of arytenoid cartilage

Insertion: musclular process of contralateral arytenoid cartilage

Action: laryngeal sphincter

Innervation: recurrent laryngeal nerve branch of vagus nerve

Blood Supply: superior laryngeal artery branch of superior thyroid artery (external carotid artery) and inferior laryngeal artery branch of inferior thyroid artery (thyrocervical trunk)

 

Aryepiglotic Muscle

Origin: fibers of oblique arytenoid muscle

Insertion: lateral border of epiglotis

Action: laryngeal sphincter

Innervation: recurrent laryngeal nerve branch of vagus nerve

Blood Supply: superior laryngeal artery branch of superior thyroid artery (external carotid artery) and inferior laryngeal artery branch of inferior thyroid artery (thyrocervical trunk)

 

Thyroepiglotic Muscle

Origin: fibers of thyroarytenoid muscle in aryepiglotic folds

Insertion: epiglotis

Action: laryngeal sphincter

Innervation: recurrent laryngeal nerve branch of vagus nerve

Blood Supply: superior laryngeal artery branch of superior thyroid artery (external carotid artery) and inferior laryngeal artery branch of inferior thyroid artery (thyrocervical trunk)

 

MUSCLES OF MASTICATION

All supplied by mandibular nerve branch of trigemminal nerve

All blood supplied by maxillary artery branch of external carotid artery

 

Masseter Muscle

mastication, deep to parotid gland, parotid duct crosses anteriorly

Origin: zygomatic process of maxilla, zygomatic arch

Insertion: angle, ramus and coronoid process of mandible

Action: closes lower jaw, deviates mandible

Innervation: masseteric nerve branch of mandibular nerve (trigemminal nerve)

Blood Supply: masseteric artery branch of maxillary artery (external carotid artery)

 

Lateral Pterygoid Muscle

Origin: two heads (1) superior : greater wing of sphenoid (2) inferior : lateral surface of lateral ptergoid plate (ethmoid)

Insertion: neck of mandible, articular disc of tempromandibular joint

Action: deviates mandible, protrudes mandible, closes mandible (superior head), opens jaw (inferior head)

Innervation: lateral pterygoid nerve branch of mandibular nerve (trigemminal nerve)

Blood Supply: lateral pterygoid artery branch of maxillary artery (external carotid artery)

 

Medial Pterygoid Muscle

Origin: medial surface of lateral pterygoid plate (ethmoid), palatine bone, pterygoid fossa

Insertion: mandibular ramus, angle of mandible

Action: closes lower jaw, protrude mandible

Innervation: medial pterygoid nerve branch of mandibular nerve (trigemminal nerve)

Blood Supply: medial pterygoid artery branch of maxillary artery (external carotid artery)

 

Temporalis Muscle

Origin: temporal fossa, temporal fascia

Insertion: coronoid process of mandible, ramus of mandible

Action: closes lower jaw, deviates mandible

Innervation: deep temporal nerve branch of mandibular nerve (trigemminal nerve)

Blood Supply: deep temporal artery branch of maxillary artery (external carotid) artery

 

MUSCLES OF FACIAL EXPRESSION

 

Orbicularis Occuli Muscle

ocul = eye

Origin: nasal process of frontal bone, palpebral ligament, lacrimal creast of lacrimal bone

Insertion: around orbit meeting in palpebral raphe, blends with other muslces

Action: closes the eye

Innervation: temporal nerve and zygomatic nerve branches of facial nerve

Blood Supply: opthalmic artery and angular artery branch of facial artery

 

Corrugator Supercilli Muscle

Origin: frontal bone above nose

Insertion: skin of medial eyebrows

Action: draws eyebrows down and medially

Innervation: temporal nerve and zygomatic nerve branchs of facial nerve

Blood Supply: opthalmic artery and superficial temporal artery branch of external carotid artery

 

Orbicularis Oris Muscle

oris = mouth

Origin: alveolar border or maxilla, lateral to midline of mandible

Insertion: around mouth, blends with other muslces

Action: closes lips, protrudes lips

Innervation: buccal nerve of facial nerve

Blood Supply: facial artery branch of external carotid artery

 

Levator Labbi Superior Muscle

labi = lip

Origin: frontal process of maxilla

Insertion: upper lip muscles, nasal cartilage

Action: elevates upper lip, flares nostrils

Innervation: buccal nerve of facial nerve

Blood Supply: facial artery branch of external carotid artery

 

Levator Anguli Oris Muscle

Origin: maxilla inferior to infraorbital foramen

Insertion: modiolus (angle of mouth)

Action: lifts agle of mouth

Innervation: buccal nerve of facial nerve

Blood Supply: facial artery branch of external carotid artery

 

Buccinator Muscle

bucc = cheek, pierced by parotid duct

Origin: posterior alveolar processes of mandible and maxilla

Insertion: modiolus (angle of mouth)

Action: compresses cheeks, prevents food from entering cheeks

Innervation: buccal nerve of facial nerve

Blood Supply: facial artery branch of external carotid artery

 

Risorius Muscle

laughter

Origin: parotid fascia

Insertion: modiolus (angle of mouth)

Action: draws mouth laterally

Innervation: buccal nerve of facial nerve

Blood Supply: facial artery branch of external carotid artery

 

Zygomaticus Major Muscle

blends with orbicularis oris

Origin: zygomatic bone

Insertion: modiolus (angle of mouth)

Action: lifts and raises angle of mouth

Innervation: buccal nerve of facial nerve

Blood Supply: facial artery branch of external carotid artery

 

Zygomaticus Minor Muscle

Origin: zygomatic bone

Insertion: skin of upper lip

Action: elevates upper lip

Innervation: buccal nerve of facial nerve

Blood Supply: facial artery branch of external carotid artery

 

Mentalis Muscle (chin)

Origin: mandible below incisors

Insertion: skin of chin

Action: protrudes lower lip, wrinkles chin

Innervation: mandibular nerve of facial nerve

Blood Supply: facial artery branch of external carotid artery

 

Drepressor Anguli Oris Muscle

Origin: oblique line of mandible, lateral mental tubercule of mandible

Insertion: modiolus (angle of mouth)

Action: lowers angle of mouth

Innervation: mandibular nerve of facial nerve

Blood Supply: facial artery branch of external carotid artery

 

Drepressor Labbi Inferior Muscle

Origin: mandible between symphysis and mental foramen

Insertion: skin of lower lip

Action: draws lower lip down and laterally

Innervation: mandibular nerve of facial nerve

Blood Supply: facial artery branch of external carotid artery

 

EPICRANIAL MUSCLES

All supplied by facial nerve, commonly known as occipitofrontalis muscle with two bellies (occipitalis muscle and frontalis muscle)

 

Frontalis Muscle

no bony attachments

Origin: galea aponeurosis

Insertion: skin above nose and eyes

Action: raiseseyebrows, wrinkles brow

Innervation: temporal nerve branch of facial nerve

Blood Supply: supraorbital artery and supratrochlear artery branches of the opthalmic artery and superficial temporal artery branch of external carotid artery

 

Occipitalis Muscle

Origin: lateral supeior nuchal line and external occipital protuberance of occipital

Insertion: galea aponeurosis

Action: draws back scalp

Innervation: posterior auricular nerve branch of facial nerve

Blood Supply: occipital artery branch of external carotid artery

 

MUSCLES OF THE TONGUE

Three extrinsic and three intrinsic muscles of the tongue all motor fibers supplied by the hypoglossal nerve and all blood supplied by branches of the external carotid artery

Palatoglossus muscle only extrinsic muscle of the tongue not supplied by hypoglossal nerve it is supplied by the pharyngeal plexus

 

Genioglossus Muscle

chin to tongue

Origin: upper genial tubercle of mandible

Insertion: under surface of tongue and hyoid bone

Action: protrudes, retracts and depresses tongue

Innervation: hypoglossal nerve

Blood Supply: sublingual artery branch of lingual artery and submental artery branch of facial artery (both from external carotid artery)

 

Styloglossus Muscle

Origin: anterior border of styloid process of temporal bone

Insertion: side of tongue

Action:

Innervation: hypoglossal nerve

Blood Supply: sublingual artery branch of lingual artery (external carotid artery)

 

Hyoglossus Muscle

Origin: sides and body of greater horn of hyoid

Insertion: side of tongue

Action: draws side of tongue down and depresses tongue

Innervation: hypoglossal nerve

Blood Supply: sublingual artery branch of lingual artery and submental artery branch of facial artery (both from external carotid artery)

 

Longitudinalis Linguae Muscle

two divisions

Origin: superior : submucous fibers at back of tongue, inferior : under surface of tongue between genioglossus muscle and hyoglossus muscle

Insertion: superior : tip of tongue to join same muscle of opposite side, inferior : tip of tongue to blend with styloglossus muscle

Action: superior : turns tip and sides up, inferior : turns tip and sides down, both shorten tongue

Innervation: hypoglossal nerve

Blood Supply: deep lingual artery branch of lingual artery and branches of facial artery (both from external carotid artery)

 

Transversus Linguae Muscle

Origin: median fibrous septum

Insertion: dorsum and sides of tongue

Action: narorws and elongates tongue

Innervation: hypoglossal nerve

Blood Supply: deep lingual artery branch of lingual artery and branches of facial artery (both from external carotid artery)

 

Verticlais Linguae Muscle

Origin: mucous membrane on dorsum of foretongue

Insertion: dorsum to under surface of tongue

Action: flatten and broaden tongue

Innervation: hypoglossal nerve

Blood Supply: deep lingual artery branch of lingual artery and branches of facial artery (both from external carotid artery)

 

MUSCLES OF THE ORBIT

4 of 6 supplied by occulomotor nerve (cranial nerve III). Others by trochela nerve (cranial nerve IV) and abducens nerve (cranial nerve VI).

(LR6SO4)3 – nerve supply of orbital muscles: lateral rectus by cranial nerve VI (trochlea nerve), superior oblique by cranial nerve IV (abducens nerve), all the rest by cranial nerve III (occulomotor nerve)

 

Levator Palpebrae Superior Muscle

Origin: roof of orbit

Insertion: superficial, middle and deep aponeurotic sheaths

Action: elevates upper eyelid (middle lamella acts involuntarily)

Innervation: occulomotor nerve

Blood Supply: supraorbital artery and muscular artery branch of opthalmic artery (internal carotid artery)

 

4 rectus muscles have a linear line of action. All but lateral rectus muscle supplied by occulomtor nerve.

 

Inferior Rectus Muscle

Origin: lesser wing of sphenoid (common tendonus ring), margin of optic canal

Insertion: posterior scelerocorneal junction

Action: depresses, laterally rotates, adducts eye

Innervation: occulomotor nerve

Blood Supply: muscular artery branch of opthalmic artery (internal carotid artery) and infraorbital artery branch of maxillary artery (external carotid artery)

 

Superior Rectus Muscle

Origin: lesser wing of sphenoid (common tendonus ring) , margin of optic canal

Insertion: posterior scelerocorneal junction

Action: elevates, medially rotates and adducts eye, intorsion

Innervation: occulomotor nerve

Blood Supply: supraorbital artery and muscular artery branch of opthalmic artery (internal carotid artery)

 

Lateral Rectus Muscle

Origin: lesser wing of sphenoid (common tendonus ring) , margin of optic canal

Insertion: posterior scelerocorneal junction

Action: abducts eye

Innervation: abducens nerve

Blood Supply: muscular artery branch of opthalmic artery (internal carotid artery)

 

Medial Rectus Muscle

Origin: lesser wing of sphenoid (common tendonus ring) , margin of optic canal

Insertion: posterior scelerocorneal junction

Action: adducts eye

Innervation: occulomotor nerve

Blood Supply: muscular artery branch of opthalmic artery (internal carotid artery)

 

Oblique muscles have a non linear line of action.

 

Superior Oblique Muscle

Origin: body of sphenoid

Insertion: superior posterior lateral sclera via trochlea

Action: depresses, medially rotates, abducts eye

Innervation: trochlear nerve

Blood Supply: muscular artery branch of opthalmic artery (internal carotid artery)

 

Inferior Oblique Muscle

Origin: orbital surface of maxilla

Insertion: inferior posterior lateral sclera via trochlea

Action: elevates, laterally rotates, abducts eye

Innervation: occulomotor nerve

Blood Supply: muscular artery branch of opthalmic artery (internal carotid artery) and infraorbital artery branch of maxillary artery (external carotid artery)

 

SUPERFICIAL NECK MUSCLES

 

Platysma Muscle

broad, flat

Origin: subcutaneous skin over delto-pectoral region

Insertion: skin over mandible

Action: depresses mandible and lower lip, tenses skin of lower neck

Innervation: cervical nerve branch of facial nerve

Blood Supply: superficial vessels of neck

 

Sternocleidomastoid  Muscle

sternum, clavicle and mastoid process of temporal bone

deep to platysma muscle, limit of posterior and anterior triangles of neck, two heads

Origin: medial : manubrium, lateral : medial clavicle

Insertion: mastoid process of temporal bone

Action: ipsilateral rotation, neck flexion, lateral flexion of neck

Innervation: motor supply by spinal accessory nerve branch of accessory nerve, sensory supply by ventral rami of C2 and C3

Blood Supply: superior portion supplied by branch of occipital artery (external carotid artery), inferior portion supplied by branch of superior thyroid artery(external carotid artery)

 

Trapezius Muscle

Origin: occipital bone, spines of C7 and all thoracic vertabrae

Insertion: acromium and spine of scapula and lateral third of clavicle

Action: extends head, stabilises, retracts, raises, rotates, adducts, elevates and depresses scapula

Innervation: motor supply by spinal accessory nerve branch of accessory nerve, sensory supply by ventral rami of C3 and C4

Blood Supply: transverse cervical artery branch of thyrocervical trunk

 

INFRAHYOID MUSCLES

Upper portions supplied by superior root of ansa cervicalis (C2), lower portions by inferior root of ansa cervicalis (C2, C3)

All supplied mainly by inferior thyroid artery (thyrocervical trunk) but also superior thyroid artery (external carotid artery)

 

Thyrohyoid Muscle

superior continuation of sternothyroid muscle

Origin: oblique line of thyroid cartilage

Insertion: body of hyoid

Action: depresses hyoid, elevates larynx

Innervation: C1 through decendens hyperglossi

Blood Supply:

 

Omohyoid Muscle

two bellies, omo = shoulder

Origin: superior belly : lateral hyoid, inferior belly : superior scapula

Insertion: clavicle by pulley tendon

Action: depresses and retracts hyoid and larnyx

Innervation: ansa cervicalis (C2, C3)

Blood Supply: infrahyoid artery branch of superior thyroid artery and sternocleidomastoid artery (external carotid artery)

 

Sternohyoid Muscle

Origin: posterior manubrium, sternal end of clavicle

Insertion: body of hyoid

Action: depresses hyoid and larnyx

Innervation: ansa cervicalis

Blood Supply: infrahyoid artery branch of superior thyroid artery and lingual artery (external carotid artery)

 

Sternothyroid Muscle

Origin: posterior manubrium

Insertion: oblique line of thyroid cartillage

Action: depresses hyoid and larnyx

Innervation: ansa cervicalis

Blood Supply: infrahyoid artery branch of superior thyroid artery (external carotid artery)

 

SUPRAHYOID MUCLES

 

Mylohyoid Muscle

myo = molar

Origin: internal mandible

Insertion: body of hyoid and mediam raphe (middle join of muscle)

Action: elevates hyoid, raises floor of mouth, depresses mandible when hyoid fixed

Innervation: mylohyoid nerve branch of mandibular nerve (trigemminal nerve)

Blood Supply: mylohyoid artery branch of inferior alveolar artery, branch of maxillary artery (external carotid artery)

 

Stylohyoid Muscle

Origin: styloid process of temporal bone

Insertion: lateral hyoid

Action: pulls hyoid superiorly and posteriorly during swallowing

Innervation: facial nerve

Blood Supply: facial artery and occipital artery

 

Posterior Digastric Muscle

Origin: mastoid process of temporal bone

Insertion: lateral hyoid (greater horn) by pulley tendon

Action: combined action of posterior and anterior drepresses mandible to open mouth, fixes hyoid

Innervation: facial nerve

Blood Supply: branch of external carotid artery

 

Anterior Digastric Muscle

deep to submandibular gland

Origin: internal lower mandible

Insertion: lateral hyoid (greater horn) by pulley tendon

Action: combined action of posterior and anterior drepresses mandible to open mouth and fixes hyoid

Innervation: mylohyoid nerve branch of mandibular nerve (trigemminal nerve)

Blood Supply: branch of external carotid artery

 

Geniohyoid Muscle

genio = chin

Origin: inner surface of mandible

Insertion: body of hyoid

Action: elevates tongue, depresses mandible, works with mylohyoid muscle

Innervation: branch of C1 following hypoglossal nerve

Blood Supply: lingual artery branch of external carotid artery

 

 

 

 

Fascia of the Head & Neck

<Head & Neck Anatomy>

 

 

 

 

Trigger Points of the Head & Neck

<Head & Neck Anatomy>

 

 

 

 

Arterial Supply of the Head & Neck

<Head & Neck Anatomy>

 

 

Arteries of the head and neck arise from the thyrocervical artery and vertebral artery branches of the subclavian artery as well as the common carotid artery which arises from the brachiocephalic artery on the right and the aortic arch on the left.

 

Carotid Sheath

fuses with the pretracheal fascia (surrounds the food and air passages as they pass from the neck into the upper thorax), prevertebral fascia, investing layer of deep cervical fascia

carotid body, carotid sinus baroreceptor (blood pressure)

 

Common Carotid Artery

The common carotid artery branches off the brachiocephalic artery on the right and off the aortic arch on the left. It branches to form the external carotid artery and internal carotid artery

External Carotid Artery :

n      Ascending Pharyngeal artery branches posteriorly, supplies palatoglossus muscle, palatopharyngeus muscle, inferior pharyngeal constrictor muscle

n      Superior Thyroid artery branches anteriorly, accompanies external superior laryngeal nerve branch of vagus nerve

( trachea, oesophagus)

n      Infrahyoid artery which supplies sternothyroid muscle, sternohyoid muscle, omohyoid muscle, thyrohyoid muscle

n      Superior Laryngeal artery which supplies cricothyroid muscle, posterior cricoarytenoid muscle, lateral cricoaretynoid muscle, transverse arytenoid muscle, vocalis muscle, thyroarytenoid muscle, oblique arytenoid muscle, aryepiglotic muscle, thyroepiglotic muscle, thyroid gland, upper parts of larynx and laryngeal part of pharynx, accompanies internal superior laryngeal nerve branch of vagus nerve to pierce thyroid membrane and enter the pharynx

n      Sternocleidomastoid artery which supplies superior portions of sternocleidomastoid muscle, inferior omohyoid muscle

n      Lingual artery which supplies sternohyoid muscle and branches anteriorly

n      Dorsal Lingual artery

n      Deep Lingual artery which supplies longitudinalis linguae muscle, transversus linguae muscle, verticalis linguae muscle

n      Sublingual artery which supplies genioglossus muscle, hyoglossus muscle, styloglossus muscle

n      Occipital artery branches posteriorly, accompanies greater occipital nerve, pierces trapezius and supplies most of the posterior half of the scalp

n      Sternocleidomastoid artery which supplies inferior portions of sternocleidomastoid muscle

n      Posterior Auricular artery which supplies occipitalis muscle, posterior auricular muscle branches posteriorly

n      Stylomastoid artery which supplies stapedius muscle

n      Facial artery branches anteriorly

n      Submental artery which supplies genioglossus muscle, hyoglossus muscle

n      Ascending Palatine artery which supplies uvula muscle, palatoglossus muscle, palatopharyngeus muscle

n      Inferior Labial artery

n      Superior Labial artery

n      Lateral Nasal artery

n      Angular artery which supplies orbicularis occuli muscle

       External Carotid artery then enters medial to the parotid gland

n      Maxillary artery branches anteriorly

n      Deep Auricular artery

n      Anterior Tympanic which supplies stapedius muscle

n      Middle Meningeal artery which enters cranial cavity

n      Superior Tympanic artery which supplies stapedius muscle, tensor tympani muscle

n      Accessory Meningeal artery

n      Inferior Alveolar artery

n      Mylohyoid artery which supplies mylohyoid muscle

n      Masseteric artery which supplies masseter muscle

n      Pterygoid artery

n      Anterior Deep Temporal artery which supplies temporalis muscle

n      Posterior Deep Temporal artery which supplies temporalis muscle

n      Buccal artery which supplies buccinator muscle

n      Posterior Superior Alveolar artery

n      Pharyngeal artery

n      Sphenopalatine artery enters nasal cavity through sphenopalatine foramen

n      Artery to Pterygoid Canal artery

n      Infraorbital artery which supplies inferior rectus muscle, inferior oblique muscle

n      Middle Superior Alveolar artery

n      Anterior Superior Alveolar artery

n      Superficial Temporal artery which supplies frontalis muscle, anterior auricular muscle, superior auricular muscle and divides :

n      Transverse Facial artery

n      Middle Temporal artery which supplies temporalis muscle

and then passes through the parotid gland.

 

As Sarah Lies Flat Oscars Penis Swells Majestically - major branches of external carotid artery

 

Internal Carotid Artery :

Passes into the carotid canal (temporal bone) and moves from lateral to medial along foramen lacerum to enter at its medial margin. Lies within the cavernous sinus as the carotid siphon. Supplies the dura, hypophysis, typanic cavity, trigemminal ganglion, optic nerve, optic chiasm, hypothalamus and genu of internal capsule. Gives off…

n      Opthalmic Artery which passes through the optic canal with the optic nerve and has nine (9) divisions :

n      Dorsal Nasi artery

n      Cilliary artery

n      Muscular artery which supplies lavator palpabrae superior muscle, superior oblique muscle, superior rectus muscle, inferior rectus muscle, inferior oblique muscle, medial rectus muscle, lateral rectus muscle

n      Supratrochlear artery

n      Supraorbital artery which supplies lavator palpabrae superior muscle, superior rectus muscle

n      Anterior Ethmoidal artery

n      Posterior Ethmoidal artery

n      Central Retinal artery is the only blood supply to the inner five layers of the retina

n      Lacrimal artery

n      Lateral Palpebral artery

n      Medial Palpebral artery which communicates with medial branch of opthalmic artery anterior to anterior ethmoidal artery

Internal carotid artery then becomes

n      Anterior Cerebral artery passing anteriorly, supplies the optic chiasm, medial surface of frontal lobe and parietal lobe, corpus callosum, leg and foot areas of paracentral lobule (motor and sensory cortices) and give of a branch …

n      Medial Striate Artery of Heubner which supplies the caudate nucleus, putamen and anterior limb of internal capsule

Left and right anterior cerebral arteries are joined via the …

n      Anterior Communicating artery

n      Middle Cerebral artery laterally as the internal carotid artery bifurcates, supplies lateral convexity of the hemisphere, insula, trunk arm and face areas of paracentral lobule (motor and sensory cortices), Broca area, Wernicke’s area, caudate nucleus, putamen and globus pallidus and branches as …

n      Lateral Striate artery to supply the anterior and posterior limbs of the internal capsule

The middle cerebral artery then passes posteriorly and becomes the …

n      Posterior Communicating artery arises from the carotid siphon and joins the posterior cerebral artery, supplies optic chiasm, optic tract, hypothalamus, subthalamus and anterior half of ventral thalamus

n      Anterior Choroidal artery supplies the choroid plexus of the temporal horn and lateral ventricle, hippocuampus, amygdala, optic tract, lateral geniculate body, globus pallidus, ventral part of posterior limb of internal capsule, proximal portion of optic radiations as they leave the lateral geniculate body (Meyer’s Loop)

n      Posterior Cerebral artery which supplies posterior half of thalamus, medial geniculate body, lateral geniculaet body, occipital lobe, visual cortex, inferior surface of temporal lobe,

n      Lateral Posterior Choroidal artery which supply dorsal thalamus, pineal body and choroid plexus of third and lateral ventricles

n      Medial Posterior Choroidal artery which supply dorsal thalamus, pineal body and choroid plexus of third and lateral ventricles

The left and right posterior cerebral arteries which has a branch passing medially to the from the…

n      Basilar artery which are formed by the fusion of the left and right vertebral arteries, gives rise to…

n      Pontine artery supplies corticospinal tracts and inta-axial exiting fibers of abducens nerve

n      Short Circmferential artery

n      Penetrating Circumferential artery

n      Anterior Inferior Cerebellar artery supplies the inferior surface of cerebellum, facial nucleus and intra-axial fibers of facial nerve, spinal trigemminal nucleus and spinal trigemminal tract, vestibular nuclei, cochlear nuclei, intra-axial fibers of vestibulocochlear nerve, spinothalamic tract and hypothalospinal tract

n      Labrynthine artery supplies the cochlea and vestibular apparatus

n      Superior Cerebellar artery supplies the superior surface of cerebellum, dentate nucleus, rostral pons, lateral pons, superior cerebellar peduncle and spinothalamic tract

n      Posterior Cerebral artery

 

Circle of Willis

Formed by anterior communicating artery, anterior cerebral artery, internal carotid artery, posterior communicating artery and posterior cerebral artery

 

Vertebral Artery :

The vertebral artery branches off the subclavian artery and is medial to the internal carotid artery it supplies the muscles of the suboccipital region : rectus capitis posterior minor muscle, rectus capitits posterior major muscle, obliquis capitis inferior muscle, obliquis capitis superior muscle.

n      Anterior Spinal artery supplies the anterior two thirds of spinal cord including lateral horn and ventral horn, pyramids, medial leminiscus, intra-axial fibers of hypoglossal nerve in medulla

n      Posterior Inferior Cerebellar artery supplies the dorsolateral zone of medulla, inferior surface of cerebellum, choroid plexus of fourth ventricle, medial vestibular nuclei, inferior vestibular nuclei, inferior cerebellar peduncle, nucleus ambiguis, intra-axial fibers of glossopharyngeal nerve and vagus nerve, spinothalamic tract, spinal trigemminal nucleus, spinal tirgemminal tract, hypothalamospinal tract, gives rise to …

n      Posterior Spinal artery supplies posterior one third of spinal cord including dorsal horn and dorsal column, gracile fasciculus, cuneate fasciculus, gracile nucleus, cuneate nucleus

The left and right verterbal arteries fuse to form the basilar artery superiorly approximately at the level of the pontomedullary junction

 

Thyrocervial Trunk :

The thyrocervical trunk branches off the subclavian artery and divides :

n      Inferior Thyroid artery which supplies the thyroid gland

n      Inferior Laryngeal artery which supplies posterior cricoarytenoid muscle

n      Transverse Cervical artery

 

 

 

Venous Drainage of the Head & Neck

<Head & Neck Anatomy>

 

External Jugular Vein

external jugular vein feeds into the brachiocephalic vein and lies superficial to sternocleidomastoid muscle

n      Suprascapular vein

n      Transverse Cervical vein

n      Anterior Jugular vein

n      Jugular Arch which joins its counterpart

n      Communicating vein to join Common Facial vein of Internal Jugular vein

n      Posterior Auricular from behind the ear

n      posterior division of Retromandibular vein is fed from

n      Retromandibular vein

n      Superficial Temporal vein

n      Maxillary vein

n      Transverse Facial vein

n      anterior division of Retromandibular vein is fed from

n      Facial vein

n      Deep Facial vein

n      Infraorbital vein

n      Angular vein

n      Supraorbital vein

n      Supratrochlear vein

n      communicates with Internal Jugular vein via common facial

 

Internal Jugular Vein

Internal Jugular vein feeds into Brachiocephalic vein

n      Common Facial vein joins with anterior division of Retromandibular vein

n      Continues into

Opthalmic Vein

 

SINUSES

Sigmoid sinus is a continuation of the transverse sinus, joins with internal jugular vein

Occipital Sinus lies in the falx cerebri and drains into the confluence of sinuses

Petrosquamous sinus

Basillar Plexus sinus connets inferior petrosal sinuses, communicates with internal vertebral venous plexus

Straight Sinus runs along attachment of falx cerebri to tentorium cerebelli, joins inferior sigital sinus to transverse sinus

Sphenoparietal sinus lies along posterior edge of lesser wing of sphenoid, drains into cavernous sinus

Superior Sagital sinus midline of convex border of falx cerebri

Marginal

Superior Petrosal sinus lies in margin of tentorium cerebelli, travels from posterior cavernous sinus into transverse sinus

Inferior Petrosal sinus drains cavernous sinus into internal jugular vein, runs in groove between petrous part of temporal and basilar part of occipital

Midle Meningeal sinus

Cavernous sinus located either side of sella turcica and body of sphenoid, internal carotid artery and abducens nerve pass through, occulomotor, trochlear, opthalmic and maxillary nerves travel froward in lateral wall, communicates with pterygoid venous plexus by emissary veins, recieves superior opthalmic vein

 

 

 

Lymphatic Drainage of the Head & Neck

<Head & Neck Anatomy>

 

 

 

 

Innervation of the Head & Neck

<Head & Neck Anatomy>

                                                 

 

CRANIAL NERVES (TWELVE)

All originate from the brain superior to the spinal cord.

Carry special sensory, general somatic efferent and afferent, general visceral efferent and afferent (parasympathetic)…

 

“2,2,4,4”

2 - I, II originate from the forebrain

2 - III, IV originate from the midbrain

4 - V, VI, VII, VIII originate from the pons

4 - IX, X, XI, XII originate from the medulla

 

“Ooh, Ooh, Ooh, To Touch And Feel Virgin Girls Vaginas And Hymens” - order of cranial nerves

“Some Say Marry Money But My Brother Says Bad Boys Marry Money” - order of sensory or motor

 

I - The Olfactory Nerve

Olfaction (smell)

FUNCTION : sensory

Origin: forebrain

PASSAGE : cribriform palate of ethmoid bone

cell bodies located in nasal mucosa, continues on to brain as olfactory bulbs

 

II - The Optic Nerve

Vision, “tract of the brain”

FUNCTION : sensory

Origin: forebrain

PASSAGE : optic canal of sphenoid bone

ganglion cells located in the retina, accompanied by opthalmic artery through optic foramen to optic chiasma and continues on to opposite side of the brain as optic tracts

 

III - The Occulomotor Nerve

Occular (eye) movement

FUNCTION: motor

Origin: mid-brain

PASSAGE : superior orbital fissure of sphenoid bone

supplies four of six extrinsic muscles for eye movement : medial rectus muscle, inferior rectus muscle, superior rectus muscle and inferior oblique muscle as well as the dilator pupillae muscle and cilliary muscles (focal length) and levator palpebrae superior muscle

 

IV - The Trochlea Nerve

Passes through the trochela (L. pulley)

FUNCTION: motor

Origin: dorsal mid-brain (only cranial nerve to originate from dorsal surface of brain)

PASSAGE : superior orbital fissure

supplies superior oblique muscle for eye movement (depresses medially rotated eye, abducts and medially rotates)

 

V - The Trigeminal Nerve

teeth, skin of face, muscles (including mastication)

trigeminal ganglion inside of cranium

FUNCTION: sensory and motor (only Mandibular nerve)

Origin: pons

sensory supply to the skin of most of the face

scalp receives sensory branches from all three divisions of the trigeminal nerve

Trigeminal ganglion divides into three branches :  Opthalmic nerve, Maxillary nerve, Mandibular nerve

n      Opthalmic Nerve

five branches reach skin of face : Supraorbital nerve, Supratrochlear nerve, Lacrimal nerve, Infratrochlear nerve, Anterior Ethmoidal nerve

sensory supply to upper eyelid, forehead, anterior scalp, dorsum and upper nose

FUNCTION : sensory

PASSAGE : Divides into three branches within cavernous sinus all of which pass through superior orbital fissure (ethmoid):

n      Frontal nerve which divides :

n      Supraorbital nerve laterally which passes through supraorbital foramen (frontal) and then superficialy supplying forehead and scalp

n      Supratrochlear nerve medially which passes superiorly out of the orbit medial to supraorbital nerve to supply medial forehead and scalp

n      Lacrimal nerve which supplies the lacrimal gland, upper eyelid and is joined by a branch of the zygomatic nerve (mandibular branch of trigemminal)

n      Nasociliary nerve which divdes :

n      Short Ciliary nerve which supplies the ciliary ganglion (which also contains motor fibers from occulomotor nerve which supply pulillary constrictors and cilliary muscles)

n      Long Ciliary nerve which feeds into the eyeball

n      Before continuing medially to form :

n      Anterior Ethmoidal which supplies the nose tip

n      Posterior Ethmoidal

n      Infratrochlear nerve is the anterior continuation which supplies the lacrimal sack, skin of upper eyelid and upper portion of lateral nose

n      Maxillary Nerve 

sensory supply to lower eyelid, side of lower nose, upper cheek, upper lip

three branches reach skin of face : Infraorbital nerve, Zygomaticofacial nerve, Zygomaticotemporal nerve

FUNCTION : sensory

PASSAGE : foramen rotundum into pterygopalatine fossa then divides :

n      Zygomatic nerve which passses into the orbit and divides :

n      Zygomaticofacial nerve (cutaneous) which passes through zygomaticofacial foramen (maxilla) and supplies surrounding skin and lateral area of eye

n      Zygomaticoltemporal nerve (cutaneous) which passes through the anterior wall of the temporal fossa to join the lacrimal nerve branch of opthalmic nerve to sensory supply the anterior temple

n      Infraorbital nerve which divides

n      Posterior Superior Alveolar nerve which supplies posterior upper teeth and then continues on to pass through inferior orbital fissure (sphenoid)

n      Middle Superior Alveolar nerve which supplies middle upper teeth

n      Anterior Superior Alveolar nerve which supplies anterior upper teeth

It then continues on through infraorbital foramen (maxilla) to divide into :

n      Inferior Palpebral nerve which supplies lower eyelid

n      Nasal nerve which supplies ala of nose

n      Superior Labial nerve which supplies upper lip and cheek

Maxillary nerve then continues to join the pterygopalatine ganglion via the Ptergopalatine nerve and then divides :

n      Into the pterygopalatine ganglion which gives off the Posterior Superior Nasal nerve which supplies nose and palate which extends to the anterior maxilla as

n      Nasopalatine nerve which supplies mucosa of the hard palate

n      Palatine nerve which supplies the palate and divides

n      Posterior Inferior Nasal nerve which supplies the nose and palate

n      Lesser Palatine nerve to back of throat

n      Greater Palatine nerve along roof of mouth

n      Nerve of the Pterygoid Canal which divides to :

n      Join the greater petrosal nerve of the facial nerve which joins the geniculate ganglion

n      Deep Petrosal nerve which joins the internal carotid nerve

n      Mandibular Nerve

sensory supply to anterolateral ear, from ear to scalp, tympanic membrane, external auditory meatus, cheek, lower lip, chin, supplies muscles of mastication

three branches reach skin of face : Mental nerve, Buccal nerve, Auriculotemporal nerve

FUNCTION : sensory and motor

PASSAGE : sensory and motor roots join and pass through foramen ovale then divide :

n      To form an Anterior Division of Mandibular nerve

n      Lateral Pterygoid nerve which supplies lateral pterygoid muscle

n      Buccal  nerve which supplies sensory to entire thickness of cheek

n      Masseteric nerve which supplies masseter muscle

n      Posterior Deep Temporal nerve which supplies posterior portion of temporalis muscle

n      Anterior Deep Temporal nerve which supplies anterior portion of temporalis muscle

n      Medial Pterygoid nerve which supplies medial pterygoid muscle

n      Auriculotemporal nerve which supplies anterolateral ear, external accoustic meatus, lateral skin of head, tempromandibular joint, tympanic membrane, parotid gland, from ear to scalp

n      Inferior Alveolar nerve which gives off a branch:

n      Mylohyoid nerve which supplies mylohyoid muscle, anterior digastric muscle

Inferior Alveolar nerve then enters the mandibular foramen (mandible) to supply sensory to the lower molar and premolar teeth and divides terminally :

n      Incisor nerve which supplies the icisor teeth and canine teeth

n      Mental nerve which passes through the mental foramen (mandible) as three branches to supply sensory to the chin, lower lip and gingiva

n      Lingual nerve which supplies sensory (touch) fibers to anterior two thirds of tongue and is joined by chorda tympani nerve of the facial nerve, it supplies secretomotor fibers to the sublingual gland, it continues and gives branches to supply the submandibular ganglion which supplies the submandibular gland

facial communicating nerve

otic ganglion (tensor tympani muscle)

tensor veli palatini muscle

 

VI - The Abducens Nerve (lateral eye movement)

FUNCTION : motor

Origin: pons

PASSAGE : superior orbital fissure of sphenoid

Passes through cavernous sinus before entering superior orbital fissure

Supplies lateral rectus muscle for eye movement

 

VII - The Facial Nerve (facial expression)

geniculate ganglion inside facial canal

FUNCTION : motor and sensory

Origin: pons

PASSAGE : into internal acoustic meatus (temporal) and out of stylomastoid foramen (temporal), supplies stapedius muscle and passes alongside vestibulocochlear nerve whilst passing through inner ear

Two deep branches:

n      Joins pterygopalatine ganglion of trigemminal nerve as Greater Pertrosal nerve carrying parasympathetic nerve fibers to nasal mucosa and lacrimal gland

n      Contributes to the tympanic plexus of the glossopharyngeal nerve

n      Contributes to the inferior ganglion of the vagus nerve

n      Another branch divides :

n      To join mandibular nerve branch of trigemminal nerve as Chorda Tympani nerve then divides :

n      To join lingual nerve of trigemminal carrying sensory fibers for taste to anterior two thirds of tongue

n      To join submandibular ganglion of trigemminal nerve carrying parasympathetic nerve fibers to submandibular and sublingual glands and anterior two thirds of tongue (secretions)

n      To pass through stylomastoid foramen inferior-superficially

From stylomastoid foramen divides :

n      To supply stylohyoid muscle and posterior digastric muscle

n      As Posterior Auricular nerve which supplies posterior auricular muscle, occipitalis muscle

n      To enter the parotid gland and then exits as five superficial branches which supply motor fibers to muscles of facial expression (still as facial nerve):

n      Temporal nerve which supplies frontalis muscle, anterior auricular muscle, superior auricular muscle, corrugator supercill muscle, orbicularis occuli muscle

n      Zygomatic nerve which supplies orbicularis occuli muscle, corrugator supercilli muscle

n      Buccal nerve which supplies buccinator muscle, risorius muscle, zygomaticus major muscle, zygomaticus minor muscle, levator labi superior muscle, levator anguli oris muscle, orbicularis oris muscle

n      Marginal Mandibular nerve which supplies depressor anguli oris muscle, depressor labi inferior muscle, mentalis muscle, orbicularis oris muscle

n      Cervical nerve which supplies platysma muscle

 

“Tall Zulus Bear Many Children” - superficial branches of the facial nerve

 

VIII - The Vestibulocochlear Nerve

Vestibule (balance), Cochelar (hearing)

FUNCTION : sensory

Origin: pons

PASSAGE : internal acoustic meatus of temporal

Divides whilst in temporal bone into :

n      Vestibular nerve which becomes the Vestibular Ganglion (balance)

n      Cochlear nerve which becomes the Cochlear Ganglion  (Spiral Ganglion) (hearing)

 

IX - The Glossopharyngeal Nerve

Glossal (tongue) and pharynx

superior ganglion, inferior ganglion (larger)

FUNCTION : motor and sensory

Origin: medulla

PASSAGE : jugular foramen (between temporal and occipital)

Joins otic ganglion of trigemminal nerve as lesser petrosal nerve supplying preganglionic parasympathetic fibers, communicates with the vagus nerve

With the pharyngeal nerve branch of the vagus nerve and the sympathetic forms the pharyngeal plexus trunk which lies on the middle pharyngeal constrictor muscle

supplies inferior pharyngeal constrictor muscle, middle pharyngeal constrictor muscle, stlyopharyngeus muscle, palatine tonsil and soft palate, pharynx, sensory and taste of posterior third of tongue, carotid sinus and carotid body (carotid sinus nerve), vallate papillae

 

X - The Vagus Nerve

Vagus (L. wanderer), organs

superior ganglion, inferior ganglion (larger)

FUNCTION : motor and sensory

Origin: medulla

PASSAGE : jugular foramen (between temporal and occipital)

n      supplies motor muscles of pharynx and soft palate

n      supplies sensory fibers to larynx

n      supplies parasympathetic fibers to heart, lungs, stomach, pyloric and cardiac sphincters of stomach, gall bladder, sphincter of Odi, liver, colon

n      Carotid Sinus and Carotid Body (Carotid Sinus nerve), Nerve to the Carotid Body

n      thyroid gland

n      Superior Laryngeal nerve which divides :

n      External Laryngeal nerve which supplies cricothyroid muscle, inferior pharyngeal constrictor muscle

n      Internal Laryngeal nerve which pierces the thyroid membrane and supplies the surface of larynx, piriform recess, epiglottic vallecula, small posterior part of dorsum of tongue

n      Recurrent Laryngeal nerve which supplies all muscles of larynx : posterior cricoarytenoid muscle, lateral cricoaretynoid muscle, transverse arytenoid muscle, vocalis muscle, thyroarytenoid muscle, oblique arytenoid muscle, aryepiglotic muscle, thyroepiglotic muscle, inferior pharyngeal constrictor muscle

n      secretory to all glands (…), palatoglossus muscle, all muscles of pharynx except stylopharyngeus muscle, all muscles of palate except tensor veli palatini muscle

 

XI - The Accessory Nerve (segment follows vagus nerve)

FUNCTION : motor

Origin: medulla

PASSAGE : cranial rootlet accompanies vagus nerve containing motor fibers, spinal rootlet gives rise to spinal accessory nerve and both pass through jugular foramen

spinal accessory which supplies sternocleidomastoid muscle, trapezius muscle

 

XII - The Hypoglossal Nerve

Glossal (tongue)

FUNCTION : motor

Origin: medulla

PASSAGE : hypoglossal canal

Loops around occipital artery, and passes between external carotid artery and interal jugular vein

Before entering tounge region gives off a infrerior branch which joins ansa cervicalis and runs inferiorly as decendens hyposi to supply thyrohyoid muscle

Then continues to supply three extrinsic muscles of the tongue: hyoglossus muscle (and its subdivision chondroglossus muscle), styloglossus muscle and genioglossus muscle and three intrinsic muscles of the tongue : longitudinalis linguae muscle, transversus linguae muscle and verticalis linguae muscle

 

CERVICAL PLEXUS

Located deep to sternocleidomastoid muscle and formed of the first four cervical nerves (C1, C2, C3, C4)

Dorsal roots contain afferent sensory fibers with cell bodies in the dorsal root ganglion

Ventral roots contain efferent motor fibers with cell bodies in the anterior horn of the spinal column

Dorsal and ventral rami contain afferent and efferent fibers

 

The trapezius muscle receives sensory fibers from the third and fourth cervical nerves

 

C1 Dorsal Ramus

obliqus capitis superior muscle
rectus capitis posterior minor muscle
rectus capitis posterior major muscle
obliqus capitis inferior muscle.

 

Greater Occipital Nerve

SOURCE : C2 Dorsal Ramus

accompanies occipital artery and supplies scalp up to sensory area of opthalmic nerve, passes posterior to ear

 

Lesser Occipital Nerve

SOURCE : ventral???? rami of C2 and C3

supplies skin of scalp behind ear (posterolateral aspect of neck), passes posterior to ear

 

Third Occipital Nerve

SOURCE : dorsal ramus of C3, passes posterior to ear

 

Greater Auricular Nerve

SOURCE : ventral rami of C2 and C3

skin of ear and over parotid gland, passes anterior to ear

 

Ansa Cervicallis Nerve

SOURCE : ventral rami of C1, C2 and C3

omohyoid muscle, sternohyoid muscle, sternothyroid muscle (all infrahyoid muscles except thyrohyoid muscle)

 

PARASYMPATHETIC NERVOUS SYSTEM

 

SYMPATHETIC NERVOUS SYSTEM

Cervical Sympathetic Ganglia

Three ganglia (superior, middle and inferior). Lie anterolateral to vertebral column. Receive no white rami communicantes as more superior than most superior white rami and therefore receive preganglionic fibers from superior thoracic spinal nerves.

 

Superior Cervical Sympathetic Ganglia

Located at the level of C1 and C2

 

Middle Cervical Sympathetic Ganglia

Located anterior to inferior thyroid artery branch of thyrocervical trunk (subclavian artery) at the level of the cricoid cartilage (larynx) and transverse process of C6 anterior to vertebral artery (subclavian artery)

 

Inferior Cervical Sympathetic Ganglia

Located anterior to transverse process of C7, superior to neck of 1st rib, posterior to the origin of the vertebral artery ()

Usually fused with the 1st and sometimes the 2nd thoracic sympathetic ganglia to form the stellate ganglion (or cervicothoracic ganglion).

 

AUTONOMIC NERVOUS SYSTEM

SOMATIC NERVOUS SYSTEM

 

Phrenic Nerve (C3, C4, C5)

-  Arises from C3, C4 and C5 ventral rami

-  Nmonic: C3, 4, 5 keeps us alive = phrenic nerve innervation

-  Passes inferiorly over the superficial surface of the anterior scalene muscle

-  Supplies the diaphragm

 

 

 

 

Organs of the Head & Neck

<Head & Neck Anatomy>

 

 

 

EYE

BONES :

MUSCLES

levator palpebrae superior, superior rectus, inferior rectus, medial rectus, lateral rectus, superior oblique, inferior oblique, constrictor pupillae, cilliary muscles, dilator pupillae

GLANDS :

lacrimal

BLOOD SUPPLY

ARTERIES

opthalmic artery (interal carotid) which passes through superior orbital fissure

infraorbital branch of maxillary (exteral carotid)

VEINS

vena vorticosa, supratrochlear, supraorbital

NERVES

opthalmic branch of trigemminal nerve and all its divisions

occulomotor nerve

trochlear nerve

abducens nerve

infraorbital branch of maxillary nerve (trigemminal)

SYMPATHETIC STIMULATION

PARASYMPATHETIC STIMULATION

ASSOCIATED TISSUE

 

EAR

fenestra vestibuli (oval), fenestra cochleae (round), cochlea, vestibular apparatus,

BONES :

stapedius, incus, malleus

MUSCLES

internal : tensor tympani, stapedius

external : anterior auricular, superior auricular, posterior auricular

GLANDS :

none

BLOOD SUPPLY

ARTERIES

VEINS

NERVES

facial nerve ands its geniculate ganglion, vestibulocochlear nerve and its division into the vestibular nerve (balance) and its vestibular ganglion and cochlear nerve (hearing) and its cochlear ganglion.

Four nerves pass in front of ear from trigeminal nerve (supratrochlear, supraorbital, zygomaticotemporal, auriculotemporal) to sensory supply skin of scalp.

Four nerves pass behind ear from spinal nerves (great auricular, lesser occipital from ventral rami, greater and third occipital from dorsal rami) to sensory supply skin of scalp.

SYMPATHETIC STIMULATION

PARASYMPATHETIC STIMULATION

ASSOCIATED TISSUE

 

THYMUS

lymphatic structure

 

PAROTID GLAND

The parotid gland lies superior to facial and posterior auricular branches of external carotid artery but is inferior to superficial temporal branchs of external carotid artery. External carotid artery then passes superiomedially to the parotid gland. It lies superficial to masseter muscle and its duct passes anteriorly over masseter to pierce buccinator muscle and empty into the cheek near the second superior molar.

 

THYROID GLAND

An endocrine (ductless) gland located in the anterior, superior part of the trachea inferior to the larynx. Attaches to the fifth or sixth tracheal ring to the oblique line of the thyroid cartilage. Enclosed in a sheath which enables it to move with the trachea in swallowing and speaking. Usually larger in women. Two lobes joined medially by small isthmus. Lies deep to sternohyoid muscle, sternothyroid muscle, omohyoid muscle and anterior border of sternocleidomastoid muscle. Parafollicular cells between follicles in the connective tissue produces thyrocalitonin which lowers the level of blood calcium. Follicle cells in the simple cuboidal epithelium produce thyroglobulin. Lumen stores colloid (thyroglobulin and iodine) which eventually becomes thyroid hormone, which stimulates glucose oxidation increasing basal metabolic rate and also effects blood pressure and is important in tissue growth and development.

Cardiac and laryngeal (recurrent laryngeal, superior laryngeal) branches of the vagus nerve and branches of the cervical ganglia of the sympathetic trunk.

Apex of each lobe recieves superior thyroid artery (external carotid), base and deep lobes receives inferior thyroid artery.

Three pairs of veins drain the thyroid gland

n      superior thyroid vein at the upper end of each lobe which can join the internal jugular or facial vein

n      middle thyroid which joins internal jugular

n      inferior thyroid which follows the front of the trachea to the brachiocephalic vein

 

PARATHYROID GLAND

An endocrine (ductless) gland with paired superior and inferior lobes. Lie on the posterior surface of the thyroid capsule. Chief cells secrete parathyroid hormone which increases the level of blood calcium. Oxyfill cells are also present in the parathyroid but their function is unknown.

 

SUBMANDIBULAR GLAND

 

SUBLINGUAL GLAND

 

LACRIMAL GLAND

 

NOSE

Olfactory nerves (smell) only in superior concha pass into cribriform plate into olfactory bulbs.

 

TONGUE

n      BONES

n      MUSCLES

n      GLANDS

n      BLOOD

n      NERVES

SYMPATHETIC STIMULATION

PARASYMPATHETIC STIMULATION

ASSOCIATED TISSUE

 

 

Brain

 

5 MAIN LOBES : frontal, parietal, occipital, temporal, insula

LOBES : inferior

 

GYRI :

Opercular Gyrus : Patch A of inferior temporal lobe

Triangular Gyrus : Patch B of inferior temporal lobe

Orbital Gyrus : Patch C of inferior temporal lobe

precentral gyrus, postcentral gyrus, gyrus rectus, supramarginal gyrus, angular gyrus, middle temporal gyrus, superior temporal gyrus, inferior temporal gyrus

 

SULCI :

Central Sulcus : seperates frontal lobe from parietal lobe

Lateral Sulcus : consists of ascending ramus, anterior ramus, and posterior ramus

precentral sulcus, postcentral sulcus, calcurine fissure, superior temporal sulcus, inferior temporal sulcus, intraparietal sulcus

 

VENTRICLES :

3rd Ventricle

4th Ventricle

Lateral Ventricle

Cerebral Aqueduct

Central Canal

 

FRONTAL LOBE

personality

 

PARIETAL LOBE

“committee”, Wernick’s Area (speech text)

 

OCCIPITAL LOBE

Calcurine fissure (visual)

 

TEMPORAL LOBE

memory and hearing, Brodman’s Area (41/42) (hearing)

 

INSULA LOBE

integration, smell and taste

 

Rhomboid Fossa : floor of the 4th ventricle, contains 4 drain holes (2 pairs)

Septum Pellucidum : twin layer that separates lateral ventricels

Superior Colliculus : visual, lateral geniculate nucleus (LGN), two bulbs

Inferior Colliculus : auditory, medial geniculate nucleus (MGN), two bulbs

Corporaquadgemina : superior and inferior colliculi

Cerebral Aqueduct : joins 3rd ventricle to 4th ventricle

Broca’s Area : Patch A (Opercular Gyrus) and Patch B (Triangular Gyrus)

Corpus Collosum

Posterior Commisuary

Anterior Commisuary

Fornix

Meninges

Faux Cerebri

 

 

 

 

Regional Anatomy of the Head & Neck

<Head & Neck Anatomy>

 

 

TRIANGLES OF THE NECK

 

Posterior Triangle

floor : serratus anterior muscle, omohyoid muscle, anterior scalene muscle
Suboccipital Triangle

Anterior Triangle

bounded by : sternocleidomastoid muscle
Carotid Traingle

 

SCALP

Skin

Close subcutaneous tissue - main nerves and vessels

Aponeurosis

Loose Connective Tissue

Periostium - outer layer of skull